[Predicting factors of tumor organ-confinement in adenocarcinoma of the prostate].
OBJECTIVE
Difficulties for a precise staging of patients with prostate cancer are huge. This article presents the initial results from a study to investigate the contribution that various clinical and analytical parameters, together with the study of prostate biopsy for staging, could have on our environment.


METHODS
70 patients undergoing curative radical prostatectomy were studied through an analysis of their PSA. PSAD, and PSAD ad pre-operative levels and, in the biopsy cylinders, the tumour unilateral or bilateral nature, Gleason grade, percentage and total number of involved cylinders, and percentage of cancer length over the cylinders' total length. This data was then correlated to the pathological stage. Gleason's grade and tumoral volume of the surgical specimen.


RESULTS
97% of patients studied showed clinical organ confinement versus only 64.28% after examination of the surgical specimen. (I Kappa = 0.1). Concordance between the biopsy's Gleason grade and the prostatectomy specimens was moderate (I Kappa = 0.34). Pre-operative PSA showed no statistically significant difference (SSD) between organ-confined and non-organ-confined tumours (p = 0.15), opposite to PSAD (p = 0.039) and PSAD ad (p = 0.038) which did. The tumour's unilateral or bilateral nature in the cylinders, and the total number or percentage of affected cylinders showed no SSD with regard to organ confinement of tumours. Neither the length percentage of the affected cylinders showed SSD in relation to the tumour's organ confinement. The specimen's tumoral volume was significantly correlated to the length percentage of cancer and positive biopsies, as well as with clinical stage, PSA, PSAD, and PSAD ad.


CONCLUSIONS
Both PSAD and PSAD ad, and the sum of the biopsy's Gleason may contribute to predict the pathological stage. The percentage and total number of biopsy cylinders affected by the tumour, as well as the total length percentage of cancer affected cylinders are correlated to the tumoral volume but not to the organ confinement of the tumoral disease, not meeting the clinical stage in our patients (selected according to our group's staging algorithm). These findings must be ratified by further study of larger series.
Borque Fernando
A
A
Servicio de Urología, Hospital Miguel Servet, Zaragoza.
Allepuz Losa
C
C
Del Agua Arias
C
C
Valdivia Navarro
P
P
Ascaso Cornago
I
I
Rioja Sanz
L A
LA
D000230:Adenocarcinoma / Q000737:chemistry / Q000473:pathology*; D000368:Aged; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000737:chemistry / Q000473:pathology*
D017430:Prostate-Specific Antigen
Factores predictores de organoconfinación tumoral en el adenocarcinoma de próstata.